Could using television as a babysitter have adverse effects on a child?

It’s possible, says a new study that finds the more time toddlers spend looking at screens — televisions, computers, tablets or smartphones — the more likely they are to have developmental delays.

These delays could be in communication, fine motor skills, problem-solving and personal and social skills, according to the study, published in the journal JAMA Pediatrics.

“Passive screen time, such as mindlessly watching television or videos, may not allow children to practice interactive problem-solving skills,” Dr. Jason Nagata, associate professor of pediatrics at the University of California, San Francisco, told MedPage Today.

“Screens can disrupt or displace interactions with caregivers and limit opportunities for verbal exchanges, which can impair communication and social skills,” added Nagata, who was not involved in the study.

“When screen use does not have an interactive or physical component, children are sedentary and may not be able to practice their gross motor skills.”

The study — which recruited subjects between July 2013 and March 2017 — involved more than 7,000 Japanese children and measured how many hours per day children used screens at age 1, based on their mothers’ reports. The researchers also investigated how the toddlers performed in several developmental tests at ages 2 and 4.

The results found that by age 2, kids who had up to four hours of screen time per day were up to three times more likely to experience developmental delays in communication and problem-solving skills.

And children who spent four or more hours with screens were almost five times more likely to have underdeveloped communication skills, nearly twice as likely to have subpar motor skills, and twice as likely to have underdeveloped personal and social skills.

By age 4, issues with communication and problem-solving skills were still evident, according to researchers.

The study also revealed that the mothers of children with high levels of screen time were younger and more often first-time mothers, with lower household income and maternal education level, and were more likely to have postpartum depression.

Experts were quick to caution that the study has several limitations, including the fact that the amount of screen time was self-reported by mothers, and screen time wasn’t separated by type, such as educational screen time vs. entertainment screen time.

“Not all screen time is equal. For instance, watching educational programs or video chatting with family is not the same as passively watching television or fast-paced TikTok videos,” said Nagata.

“Also, the screen time data was initially collected in 2013, and there are newer technologies, devices and apps that children may be exposed to now in 2023,” Nagata added.

In addition, the study doesn’t prove that additional screen time caused developmental delays.

“The most important point is that [these] results represent an association, not a causation. So, clinicians and/or parents need not to limit children’s screen time based on our results,” Dr. Taku Obara, of Tohoku University in Japan, told MedPage Today.